<%@ page language="java" contentType="text/html; charset=utf-8" pageEncoding="utf-8" isELIgnored="false"%>

<%
	request.setAttribute("title","泛华车险信息");
	request.setAttribute("modelConfigPath", "insu");
%>

<%@ include file="/WEB-INF/views/shared/master/contentHeader.jsp"%>

<t:panel cssClass="panel-flat form-detailed" customBody="true" customHead="true">
	<div class="detailed-navbar-content panel-body">
		<t:form commandName="fanhuaCar" action="/admin/insu/fanhuaCar/save" method="post" cssClass="form-horizontal">
            <div class="hide">
				<t:hidden path="id" />
				<t:hidden path="deleteMark" />
				<t:hidden path="customerId" />
			</div>
			<t:formgroup>
				<t:label path="taskId" cssClass="col-sm-2" />
				<t:input path="taskId" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="prvName" cssClass="col-sm-2" />
				<t:input path="prvName" colClass="col-sm-4" />
				<t:label path="taskState" cssClass="col-sm-2" />
				<t:select2 path="taskState" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="carLicenseNo" cssClass="col-sm-2" />
				<t:input path="carLicenseNo" colClass="col-sm-4" />
				<t:label path="vehicleName" cssClass="col-sm-2" />
				<t:input path="vehicleName" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="carProperty" cssClass="col-sm-2" />
				<t:select2 path="carProperty" colClass="col-sm-4" />
				<t:label path="carOwnerName" cssClass="col-sm-2" />
				<t:input path="carOwnerName" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="carOwnerPhone" cssClass="col-sm-2" />
				<t:input path="carOwnerPhone" colClass="col-sm-4" />
				<t:label path="applicantName" cssClass="col-sm-2" />
				<t:input path="applicantName" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="applicantIdcardNo" cssClass="col-sm-2" />
				<t:input path="applicantIdcardNo" colClass="col-sm-4" />
				<t:label path="applicantGender" cssClass="col-sm-2" />
				<t:select2 path="applicantGender" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="applicantIdcardType" cssClass="col-sm-2" />
				<t:select2 path="applicantIdcardType" colClass="col-sm-4" />
				<t:label path="applicantEmail" cssClass="col-sm-2" />
				<t:input path="applicantEmail" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="applicantMobile" cssClass="col-sm-2" />
				<t:input path="applicantMobile" colClass="col-sm-4" />
				<t:label path="insuredName" cssClass="col-sm-2" />
				<t:input path="insuredName" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="insuredIdcardNo" cssClass="col-sm-2" />
				<t:input path="insuredIdcardNo" colClass="col-sm-4" />
				<t:label path="insuredGender" cssClass="col-sm-2" />
				<t:select2 path="insuredGender" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="insuredIdcardType" cssClass="col-sm-2" />
				<t:select2 path="insuredIdcardType" colClass="col-sm-4" />
				<t:label path="insuredEmail" cssClass="col-sm-2" />
				<t:input path="insuredEmail" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="insuredMobile" cssClass="col-sm-2" />
				<t:input path="insuredMobile" colClass="col-sm-4" />
				<t:label path="efcInsureInfoStartDate" cssClass="col-sm-2" />
				<t:input path="efcInsureInfoStartDate" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="efcInsureInfoEndDate" cssClass="col-sm-2" />
				<t:input path="efcInsureInfoEndDate" colClass="col-sm-4" />
				<t:label path="efcInsureInfoAmount" cssClass="col-sm-2" />
				<t:input path="efcInsureInfoAmount" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="efcInsureInfoPremium" cssClass="col-sm-2" />
				<t:input path="efcInsureInfoPremium" colClass="col-sm-4" />
				<t:label path="efcInsureInfoPolicyNo" cssClass="col-sm-2" />
				<t:input path="efcInsureInfoPolicyNo" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="efcInsureInfoDiscountRate" cssClass="col-sm-2" />
				<t:input path="efcInsureInfoDiscountRate" colClass="col-sm-4" />
				<t:label path="taxInsureInfoLateFee" cssClass="col-sm-2" />
				<t:input path="taxInsureInfoLateFee" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="taxInsureInfoTaxFee" cssClass="col-sm-2" />
				<t:input path="taxInsureInfoTaxFee" colClass="col-sm-4" />
				<t:label path="bizInsureInfoStartDate" cssClass="col-sm-2" />
				<t:input path="bizInsureInfoStartDate" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="bizInsureInfoEndDate" cssClass="col-sm-2" />
				<t:input path="bizInsureInfoEndDate" colClass="col-sm-4" />
				<t:label path="bizInsureInfoPremium" cssClass="col-sm-2" />
				<t:input path="bizInsureInfoPremium" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="bizInsureInfoDiscountRate" cssClass="col-sm-2" />
				<t:input path="bizInsureInfoDiscountRate" colClass="col-sm-4" />
				<t:label path="bizInsureInfoPolicyNo" cssClass="col-sm-2" />
				<t:input path="bizInsureInfoPolicyNo" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="bizInsureInfoNfcPremium" cssClass="col-sm-2" />
				<t:input path="bizInsureInfoNfcPremium" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="totalPremium" cssClass="col-sm-2" />
				<t:input path="totalPremium" colClass="col-sm-4" />
				<t:label path="quoteValidTime" cssClass="col-sm-2" />
				<t:input path="quoteValidTime" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup >
				<t:label path="riskKinds" cssClass="col-sm-2" />
				<t:textarea style="height:100px"  path="riskKinds" colClass="col-sm-10" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="payValidTime" cssClass="col-sm-2" />
				<t:input path="payValidTime" colClass="col-sm-4" />
				<t:label path="deliveryType" cssClass="col-sm-2" />
				<t:input path="deliveryType" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="deliveryName" cssClass="col-sm-2" />
				<t:input path="deliveryName" colClass="col-sm-4" />
				<t:label path="deliveryPhone" cssClass="col-sm-2" />
				<t:input path="deliveryPhone" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="deliveryProvince" cssClass="col-sm-2" />
				<t:input path="deliveryProvince" colClass="col-sm-4" />
				<t:label path="deliveryCity" cssClass="col-sm-2" />
				<t:input path="deliveryCity" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="deliveryArea" cssClass="col-sm-2" />
				<t:input path="deliveryArea" colClass="col-sm-4" />
				<t:label path="deliveryAddress" cssClass="col-sm-2" />
				<t:input path="deliveryAddress" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="deliveryZip" cssClass="col-sm-2" />
				<t:input path="deliveryZip" colClass="col-sm-4" />
				<t:label path="deliveryExpressCompanyName" cssClass="col-sm-2" />
				<t:input path="deliveryExpressCompanyName" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="deliveryExpressNumber" cssClass="col-sm-2" />
				<t:input path="deliveryExpressNumber" colClass="col-sm-4" />
				<t:label path="quoteValidTime" cssClass="col-sm-2" />
				<t:input path="quoteValidTime" colClass="col-sm-4" />
			</t:formgroup>
			<t:formgroup>
				<t:label path="deliveryOutDept" cssClass="col-sm-2" />
				<t:input path="deliveryOutDept" colClass="col-sm-4" />
			</t:formgroup>
		</t:form>
	</div>
</t:panel>

<script type="text/javascript">
	function saveData() {
		if (!$("form:first").valid()) {
			return;
		}
		$("form:first").submit();
	}
</script>
<%@ include file="/WEB-INF/views/shared/base/scripts/jqueryui.jsp"%>
<%@ include file="/WEB-INF/views/shared/base/scripts/limitless/default/formselects.jsp"%>
<%@ include file="/WEB-INF/views/shared/base/scripts/limitless/default/formstyling.jsp"%>
<%@ include file="/WEB-INF/views/shared/base/scripts/limitless/default/formpickers.jsp"%>
<%@ include file="/WEB-INF/views/shared/master/dialog.jsp"%>
<%@ include file="/WEB-INF/views/shared/scripts/editor/ueditor.jsp"%>
<%@ include file="/WEB-INF/views/shared/base/scripts/tools/upload-cos.jsp"%>
<%@ include file="/WEB-INF/views/shared/master/contentFooter.jsp"%>
